| Spring Street Family Practice | |
|
1207 N Spring St Gladwin MI 48624 | |
| (989) 426-5553 | |
| Not Available |
| Full Name | Spring Street Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1207 N Spring St, Gladwin, Michigan |
| Authorized Official Name and Position | Janet Flynn (OWNER) |
| Authorized Official Contact | 9894265590 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Street Family Practice 801 Joe Mann Blvd Ste P-6 Midland MI 48642-8900 Ph: (989) 791-2455 | Spring Street Family Practice 1207 N Spring St Gladwin MI 48624 Ph: (989) 426-5553 |
| NPI Number | 1083790026 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 08/23/2022 |
| Certification Date | 08/23/2022 |
| Medicare PECOS PAC ID | 2961471594 |
|---|---|
| Medicare Enrollment ID | O20040929001087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083790026 | NPI | - | NPPES |
| 4458397 | Medicaid | MI | |
| 3012794 | Medicaid | MI | |
| 4640974 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4704126534 (Michigan) | Primary |
| Provider Name | Janet E Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710063755 PECOS PAC ID: 5395645212 Enrollment ID: I20040108001112 |
| Provider Name | Mary Bosman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821457854 PECOS PAC ID: 9133493976 Enrollment ID: I20170918003247 |
| Provider Name | Tammy Milbocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790209161 PECOS PAC ID: 0244506285 Enrollment ID: I20171019001034 |
| Provider Name | Nicole S Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710466024 PECOS PAC ID: 8224388152 Enrollment ID: I20180913002036 |
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